The broad long-term objective of this study is to improve nurses' ability to assess and manage pain using tools that are psychometrically sound and sensitive to needs and preferences of patients from diverse cultures and socio-economic groups. Tools using line drawn faces were developed for use with children and are reliable and valid in pediatric settings. However, faces scales have not been tested for reliability or validity when used by adults except in the PI's first preliminary study. Specific aims of this study are to identify scaling and psychometric properties a 7 face scale when used by Anglo, African-American, Hispanic, and Asian adults attending health clinics for lower income populations (N=200; 50/ethnic group; equal n's of men and women). Additional aims are to determine if psychometric or scaling properties, and decision points at which intervention to relieve pain should be initiated, or scores assigned to the faces differ as a function of ethnic background or gender. Subjects will be asked to match the amount of pain on each of the FPS faces to the intensity of light from a light box. A photographers light meter will be used to measure intensity. Mean scores for each face will be calculated by group and compared using ANOVA. Subjects are asked at what point on the FPS they think something should be done to relieve pain. Multiple regression will be used to determine scaling properties (R2, slope and intercept). Group data (gender by ethnic) will be compared. All instructions will be translated into the subjects preferred language and research assistants will be matched ethnically to subjects. Better pain assessment and increased patient satisfaction with pain management should result.